Meaningful work and fair treatment: Vital elements for street-level Bureaucrats' defence against emotional exhaustion and poor well-being

This study examines how healthcare Street-Level Bureaucrats (SLBs) working in Italian public hospitals experience organisational justice and meaningful work, and how these perceptions shape their emotional exhaustion and overall well-being. Drawing on Conservation of Resources theory, we explore how both organisational and personal resources influence resilience and strain in demanding public service environments. Based on two-wave survey data from 1306 healthcare professionals, our findings show that when SLBs perceive fair processes and respectful treatment, they are less likely to feel emotionally drained. Feeling that their work is meaningful further enhances these positive effects, helping professionals remain engaged despite high demands. However, once emotional exhaustion takes hold, it has a particularly strong impact on well-being, suggesting that the cost of resource loss may outweigh the benefits of supportive work conditions if left unaddressed. We contribute to public management literature by clarifying how perceptions of fairness and purpose at work shape well-being in frontline healthcare, and offer practical guidance for designing fairer, more supportive work environments to sustain SLB motivation and reduce burnout.